ILLIANA PHYSICIANS GROUP (NPI# 1134145493) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134145493 |
| Entity Type | Organization |
| Organization Name | ILLIANA PHYSICIANS GROUP |
| Other Organization Name | ILLIANA MEDICAL CENTER |
| Practice Address |
3550 E 118th St Chicago IL 60617-7314 |
| Practice Telephone | 7736469800 |
| Practice Fax Number | 7736469801 |
| Mailing Telephone | 7736469800 |
| Mailing Fax Number | 7736469801 |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. OSSAMA HOSNEY ZORUB (OWNER) |
| Authorized Official Telephone | 7736469800 |
| Authorized Official Credential | M. D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
IL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| illiana medical center | Doing Business As Name - Organization |
| Street Address |
3550 E 118TH ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60617-7314 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801841127 | Dorian R Finder | Family Medicine | 3550 E 118th St, Chicago, IL 60617-7314 | 2006-05-24 |
| 1114143625 | David Luyando Jr. | Chiropractor | 3550 E 118th St, Chicago, IL 60617-7314 | 2007-04-17 |
| 1326173618 | Estella Faviola Martinez | Family Medicine | 3550 E 118th St, Chicago, IL 60617-7314 | 2007-02-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871102921 | Manuel Lule | Physical Therapy Assistant | 9535 S Jeffery Boulevard, Chicago, IL 60617 | 2020-07-24 |
| 1083253546 | Vanaja Thotten | Internal Medicine | 8012 S.crandon Ave, Chicago, IL 60617 | 2020-01-02 |
| 1427527365 | Stony Island Dental PC | Dentist | 1600 E 93rd Street, Chicago, IL 60617 | 2018-11-21 |
| 1871060301 | Tamika Nicole Whitehead | Social Worker | 2822 East 83rd Street, Chicago, IL 60617 | 2018-11-02 |
| 1528543774 | Felicia Nwankwo | Nurse Practitioner | 2822 E 83rd Street Bradond Famiy Health Cener, Chicago, IL 60617 | 2018-10-03 |
| 1972099307 | David Phan | Optometrist | 1753 E 95th St Ste B-100, Chicago, IL 60617 | 2018-07-09 |
| 1831607340 | Pamela Evette Ewing | Counselor | 9145 S. Merrill Ave, Chicago, IL 60617 | 2018-01-18 |
| 1366976631 | Ali Mostafa Serhal | Radiology | 240 E. Huron St, Suite 1-203, Chicago, IL 60617 | 2017-04-13 |
| 1447784921 | 1915-25 95th St., LLC | Clinic/Center | 1915 E 95th St, Chicago, IL 60617 | 2017-04-12 |
| 1881140408 | Yeferson Laverde | Social Worker | 3062 East 31st, Chicago, IL 60617 | 2016-09-01 |
| Find all providers in zip 60617 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407484645 | Macumber Medical Ltd | Clinic/Center | 3114 W Irving Park Rd Ste 1w, Chicago, IL 60618-3435 | 2020-04-01 |
| 1689226318 | Midway Spine and Joint Pain Physicians | Clinic/Center | 5720 S Pulaski Rd, Chicago, IL 60629-4435 | 2019-07-12 |
| 1497215933 | Activate Healthcare | Clinic/Center | 2010 N Damen Ave Unit F, Chicago, IL 60647-3286 | 2019-03-21 |
| 1689989717 | A Better Weigh, Inc | Clinic/Center | 1931 W 95th St, Chicago, IL 60643-1105 | 2010-08-12 |
| 1598086399 | Bernadette B Mayer Md Sc | Clinic/Center | 5365 W Devon Ave, Chicago, IL 60646-4142 | 2010-06-15 |
| 1124295340 | Demetrios Petrovas M.d. S.c. | Clinic/Center | 3960 North Harlem Ave, Chicago, IL 60634-2219 | 2008-05-15 |
| 1689841801 | Petrovas Medical Center, S.c | Clinic/Center | 5962 N Lincoln Ave Ste 12, Chicago, IL 60659-3762 | 2008-05-15 |
| 1952577926 | Jefferson Park Medical Center, Ltd. | Clinic/Center | 4955 N Milwaukee Ave Ste 4, Chicago, IL 60630-2175 | 2008-04-30 |
| 1194833616 | Wicker Park Chiropractic Health | Clinic/Center | 2300 W North Ave, Chicago, IL 60647-5659 | 2006-08-25 |
| 1073567541 | Horizon Dante Pimentel | Clinic/Center | 4402 W Lawrence Ave, Chicago, IL 60630-2511 | 2006-05-20 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.